Modeled estimates of myocardial infarction and venous thromboembolic disease in users of second and third generation oral contraceptives.
Consistent reports from several recent studies suggest that users of third generation oral contraceptives (OCs) containing gestodene and desogestrel may be at increased risk of venous thromboembolic disease (VTE).
Paradoxically, other reports indicate that these users may be at decreased risk of acute myocardial infarction (MI) compared with users of second generation OCs.
To determine whether the potentially increased risk of VTE would outweigh the potentially reduced risk of MI in users of third generation OCs, we conducted an analysis to quantify the trade-offs providers and users may be faced to make between these formulations.
The baseline rates of VTE and MI among non-users were calculated using US data on incidence and mortality of these conditions and estimates of the proportion of women exposed to these formulations in the US.
These were multiplied by relative risks published in recent studies on third generation progestins to produce age-and formulation-specific risks.
Results indicate that there would be small differences in disease burden between users of second and third generation OCs under the model assumptions at younger ages.
However, among women 35-44 years of age, modeling results indicate that the potentially decreased incidence of MI among users of third generation OCs more than offsets the potentially increased risk of VTE at this age.
Mots-clés Pascal : Contraceptif, Voie orale, Oestroprogestatif, Thromboembolie, Infarctus, Myocarde, Toxicité, Risque, Homme, Femelle, Epidémiologie, Mortalité, Morbidité, Progestatif, Gestodène, Désogestrel, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Cardiopathie coronaire, Myocarde pathologie, Age, Etats Unis, Amérique du Nord, Amérique, Progestatif troisième génération
Mots-clés Pascal anglais : Contraceptive, Oral administration, Estroprogestagen, Thromboembolism, Infarct, Myocardium, Toxicity, Risk, Human, Female, Epidemiology, Mortality, Morbidity, Progestagen, Gestodene, Desogestrel, Cardiovascular disease, Vascular disease, Coronary heart disease, Myocardial disease, Age, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0272292
Code Inist : 002B02U03. Création : 15/07/1997.